Which U.S. states currently fund Medicaid-like programs that include undocumented immigrants, and what do those programs cover?
Executive summary
A growing subset of states has used state dollars or separate “Medicaid‑like” programs to give at least some undocumented immigrants access to health coverage, but the scope and stability of those programs vary widely and several are in flux as of 2025–2026 [1] [2]. National trackers count about 14 states that cover children or pregnant people regardless of immigration status and roughly six that have extended Medicaid‑style coverage to some undocumented adults, yet specific program ages, benefits, and timelines differ by state and are changing [3] [4] [1].
1. What “Medicaid‑like” coverage means in practice
States use two main approaches: (A) fully state‑funded programs that mimic Medicaid benefits for people excluded from federal Medicaid because of immigration status, and (B) narrower, targeted policies that cover children, pregnant people, or certain age bands with defined benefits [1] [2]. When states offer “Medicaid‑like” plans, those programs can provide comprehensive primary, specialty, hospital, and sometimes dental benefits comparable to Medicaid, but benefit packages and eligibility rules are set by each state rather than by federal Medicaid law [5] [2].
2. How many states, and which populations are covered
Public trackers and reporting show two headline figures: about 14 states provide public coverage to children and/or pregnant people regardless of immigration status, and about six states have programs that include some undocumented adults [3] [4]. Sources explicitly name states that have made major moves: California, New York, and Illinois are examples of states that have used state funds to extend coverage to some undocumented residents, while Rhode Island is cited for covering pregnant people and children regardless of status [6] [7] [8].
3. Examples of state programs and recent policy shifts
Illinois’ Health Benefits for Immigrant Adults (HBIA) offered coverage to adults in a defined age band (age 42–64) regardless of immigration status, though the state has signaled budget pressure and proposed eliminating HBIA in its FY2026 plan [8]. California created broad state‑funded coverage for undocumented adults but plans to pause enrollment for non‑pregnant adults 19+ in January 2026, to curtail some benefits like dental for non‑pregnant adults later in 2026, and to introduce premiums for certain adults starting in 2027 [9]. Minnesota extended state‑funded coverage to income‑eligible adults regardless of status in January 2025 but paused enrollment in June 2025 and planned to end coverage by January 2026 [9]. These shifts show that state programs are politically and fiscally contingent [9].
4. What is — and is not — covered under federal rules
Undocumented immigrants are ineligible for federally funded Medicaid, Medicare, and CHIP generally; federal Medicaid will reimburse only emergency services for people barred from full Medicaid, and the federal match rules are changing in ways that will affect state budgets starting in late 2026 [10] [11] [12]. Some federal options still let states draw federal funds for lawfully present pregnant people and for CHIP prenatal care expansions, but fully state‑funded programs are the mechanism states use to cover undocumented adults and other excluded groups [5] [12].
5. Political context, trade‑offs, and what reporting does not show
Advocates argue state programs reduce uninsured rates and improve public health for underserved populations; analyses show states with expansive immigrant coverage have lower uninsurance among immigrants [1] [2]. Opponents and some federal proposals warn of fiscal consequences and propose reduced federal matching that could penalize states offering such coverage [7] [13]. The sources provided do not include a full, current list of all 14 states or granular benefit‑by‑state benefit tables in the snippets, so this reporting cannot definitively list every programmatic detail for each state without consulting the state‑by‑state tables and maps maintained by NILC and KFF referenced above [3] [14] [9].